A high hairline or overly tall forehead can detract significantly from the harmony of the face, and draw attention away from other features such as the eyes.  In women, a larger forehead can give a more masculine appearance to the face.  Though the right proportion varies between people, an ideal female forehead is approximately 4.5 to 5.5cm tall (measuring from the eyebrow to the hairline).  The hairline is generally straight, without any significant recession at the temples laterally.  In the male face, this is typically a bit taller (about 6cm centrally) and some hairline recession is typically seen at the temples.

Hair Restoration For Women

In many cases, Dr. Ransom can address these specific concerns with a procedure called hairline lowering or forehead reduction.  This procedure involves a carefully planned excision of skin in the upper forehead.  First, an incision is made in the hairline, often with a saw-tooth pattern for camouflage.  Then, the scalp is elevated behind the hairline onto the top of the head.  The scalp tissue is then gently stretched using specific surgical techniques, and brought forward in front of the incision.  The scalp flap is then anchored in place with an absorbable surgical implant.  The excess forehead skin is then carefully trimmed to meet the new hairline, and the incision is closed meticulously in two layers with tiny sutures. Sutures remain in place for about a week after the procedure, and are removed in the office.

Dr. Ransom is a specialist in all types of brow and forehead surgery, and will help you select the right approach for your specific case and aesthetic goals.  For patients with an asymmetric hairline or brow (one side obviously higher than the other), an open surgical treatment of the forehead helps to achieve the best results.  For men with significant hair loss and a heavy brow, a variety of approaches can be used to elevate the brows without elevating the hairline or leaving obvious, unsightly scars in the scalp – ensuring natural-appearing results.  For more information, see the Procedures for Men section.  Hairline lowering (forehead reduction) can be combined with other facial rejuvenation or reconstructive procedures and is particularly effective when the eyelids are addressed at the same time.

Who is a candidate?

Anyone with a high hairline or tall forehead may be a candidate.  Special consideration is needed for women with very thin hair and men who are bald or have significantly receding hairlines.  In some cases, patients are better suited for hair restoration techniques, either alone or in combination with hairline lowering.  Comprehensive rejuvenation of the entire forehead, brow, and eyelid complex can be discussed with Dr. Ransom at your consultation.

Frequently Asked Questions

Please note that all patients are different and individual healing times and results may vary. The statements regarding procedures and recovery made here are general rules.

For the first night after the procedure, patients wear a soft cotton dressing. Bruising and swelling peak on day two, and then decrease steadily. This typically takes about a week, but may be faster or slower for some patients. Incisions require minimal daily care and are easily hidden under bangs or a hat. Sutures are then removed a week after the procedure. Keeping the head elevated is very helpful for the first few days.

The design of the incisions can be used to make limited changes in the shape of the forehead in some cases. For most patients, a simple decrease in the height of the forehead is desired, rather than obvious changes in forehead shape. The exception are women with some temporal hairline recession. These patients require special consideration. Finally, for patients with some asymmetry of the forehead, hairline lowering can be used to improve symmetry.

Forehead reduction or hairline lowering involves incisions placed in the hairline. There is bruising and swelling in the scalp region, but this is generally hidden beneath the remaining hair. Sutures are easily hidden by styling the remaining hair with bangs, or by wearing a hat. Patients may be able to return to work within a couple days of the procedure, though with limits on any straining and lifting.

Dr. Evan Ransom is an Ivy League-educated and Ivy League trained Facial Plastic and Reconstructive Surgeon. He is a Double Board Certified Head and Neck Surgeon and Facial Plastic and Reconstructive Surgery and fellowship-trained in facial plastic, reconstructive, and laser surgery. His practice is in the San Francisco Bay Area, serving patients from San Francisco, Oakland, Marin County, Palo Alto, Silicon Valley, Walnut Creek, the East Bay, and all over Northern California.